Fibrous adhesions are a serious complication that can arise from trauma to the body as they can lead to chronic pain, infertility, and intestinal obstruction. Adhesions are bands of fibrous tissue that join two surfaces in the body, which are not normally connected. They generally form after injury to an area that results in increased inflammation. Surgery, trauma, infections, radiation, and ischemia can all lead to adhesion formation, with surgery being the most common cause. Fibrous adhesions have an enormous impact on the healthcare system. It has been estimated that 95% of abdominal and pelvic surgeries, including gynecologic, result in adhesions. Adhesion-related problems account for 6% of all hospital readmissions and 1% of all hospitalizations in the United States. Adhesions increase surgery time, hospital stay, complications, blood loss, morbidity, and mortality.
In addition to improved surgical techniques, both pharmaceuticals and physical barriers have been explored as means to prevent adhesion formation (Tingstedt et al., Eur Surg Res 39, 259-268 (2007); Ward, et al., Journal of Surgical Research, 165(1), 91-111 (2009)). Systemic administration of such drugs at therapeutic levels can cause undesired side effects and delay healing after surgery. There have been some attempts to inject the drugs into the peritoneal cavity; however, most of these have shown little to no efficacy in laboratory testing primarily due to the tendency for drugs placed in the peritoneal cavity to be quickly absorbed by the mesothelium and subsequently distributed throughout the body. Various solids, gels, and fluids have been used as physical barriers. None of these devices have been shown efficacious enough at reducing adhesion formation to warrant their ubiquitous use.
Accordingly, there is a need for more efficacious treatments for wound healing (e.g., the mitigation of pain, inflammation and/or other complications, such as fibrous adhesions).